Trends

in Psychiatry and Psychotherapy Original Article

Brazilian Portuguese version of the

Spence Children’s Anxiety Scale (SCAS-Brasil)

Versão em português brasileiro da

Escala Spence de Ansiedade Infantil (SCAS-Brasil)

Diogo A. DeSousa,1 Circe S. Petersen,2 Rafaela Behs,3 Gisele G. Manfro,2 Silvia H. Koller2

Abstract Resumo

Objective: To describe the cross-cultural adaptation of the
Spence Children’s Anxiety Scale (SCAS) for use in Brazil.
Methods: Cross-cultural adaptation followed a four-step pro-
cess, based on specialized literature: 1) investigation of concep-
tual and item equivalence; 2) translation and back-translation;
3) pretest; and 4) investigation of operational equivalence. All
these procedures were carried out for both the child and the
parent versions of the SCAS.
Results: A final Brazilian version of the instrument, named
SCAS-Brasil, was defined and is presented.
Conclusion: The SCAS-Brasil instrument seems to be very simi-
lar to the original SCAS in terms of conceptual and item equiva-
lence, semantics, and operational equivalence, suggesting that
future cross-cultural studies may benefit from this early version.
As a result, a new instrument is now available for the assess-
ment of childhood anxiety symptoms in community, clinical, and
research settings.
Keywords: Anxiety, anxiety disorders, cross-cultural adaptation.
Objetivo: Descrever a adaptação transcultural da Escala Spence
de Ansiedade Infantil (Spence Children’s Anxiety Scale, SCAS)
para uso no Brasil.
Método: A adaptação transcultural seguiu um processo de qua-
tro etapas baseado em literatura especializada: 1) investigação
da equivalência conceitual e dos itens; 2) tradução e retrotradu-
ção; 3) pré-teste; e 4) investigação da equivalência operacional.
Todos os procedimentos foram realizados tanto para a versão da
criança quanto para a versão dos pais da SCAS.
Resultados: Uma versão final brasileira do instrumento, deno-
minada SCAS-Brasil, foi obtida e é apresentada.
Conclusão: A SCAS-Brasil se mostra muito similar à versão ori-
ginal da SCAS no que diz respeito à equivalência conceitual e dos
itens, semântica e equivalência operacional, sugerindo que futu-
ros estudos transculturais poderiam se beneficiar desta primeira
versão. Como resultado, um novo instrumento está agora dispo-
nível para a avaliação de sintomas de ansiedade na infância, em
contextos comunitário, clínico e de pesquisa.
Descritores: Ansiedade, transtornos de ansiedade, adaptação
transcultural.

1
MSc candidate, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. 2 PhD, UFRGS. 3 PhD candidate, UFRGS.
The present study was conducted by the Center for Psychological Studies on At-Risk Populations, Institute of Psychology, UFRGS, and the Anxiety Disorders
Program for Child and Adolescent Psychiatry (PROTAIA), Hospital de Clínicas de Porto Alegre (HCPA), UFRGS.
Financial support: Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).
Submitted Apr 17 2012, accepted for publication Jul 06 2012. No conflicts of interest declared concerning the publication of this article.
Suggested citation: DeSousa DA, Petersen CS, Behs R, Manfro GG, Koller SH. Brazilian Portuguese version of the Spence Children’s Anxiety Scale (SCAS-Brasil).
Trends Psychiatry Psychother. 2012;34(3):147-53.

© APRS Trends Psychiatry Psychother. 2012;34(3) – 147-153

SCAS-Brasil: Brazilian version of the SCAS – DeSousa et al.
Introduction
Anxiety disorders are among the most frequent
psychiatric illnesses in the general population.1,2
Considering the overall scenario of mental disorders,
data from international3,4 and Brazilian5-8 studies have
shown prevalence rates ranging from 6 to 20% for
anxiety disorders during childhood and adolescence.
Pediatric anxiety disorders may severely interfere
with the daily functioning of children and adolescents
and are associated with chronicity.9-11 These disorders
may also predict difficulties in adulthood, such as
anxiety and depressive disorders,12,13 substance abuse
and dependence,14 and suicidal behavior,15 especially if
inadequately diagnosed and/or left untreated.5,8,16-18 Hence,
it is important to have adequate tools for the assessment
of anxiety symptoms, as well as for the screening and
diagnosis of anxiety disorders, especially among youth.
Self-report questionnaires and scales are frequently
used in research and clinical practice for evaluating and
measuring anxiety symptoms. Among other advantages,
they are easy and fast to administer and focus on
symptoms from the point of view of the respondent.19
Instruments used to assess childhood anxiety symptoms
are mainly downward versions of instruments developed to
evaluate anxiety in adults.20 In Brazil, some examples of
instruments that follow this pattern are the State-Trait Anxiety
Inventory for Children (STAI-C),21 rendered as Inventário
de Ansiedade Traço-Estado para Crianças (IDATE-C),22 and
the Revised Children’s Manifest Anxiety Scale (RCMAS),23
translated/adapted into Escala de Ansiedade Infantil “O Que
Penso e Sinto?”24 However, it is also important to consider
that there are developmental characteristics involved in the
evaluation of childhood anxiety symptoms.20
Another important aspect to be considered about some
instruments used to assess childhood anxiety symptoms,
such as the STAI-C and the RCMAS, is that they measure
anxiety in general, and not anxiety symptoms related
to specific disorders. Nevertheless, when dealing with
diagnosis and treatment of anxiety disorders, information
about specific clusters of anxiety problems may be useful
for practitioners and investigators.20
To overcome these limitations, the Spence Children’s
Anxiety Scale (SCAS)20,25 was developed with the following
objectives: 1) to assess specific symptoms of childhood
anxiety, considering the developmental specificities of
anxiety symptoms among children; and 2) to assess
symptoms according to diagnostic criteria of the Diagnostic
and Statistical Manual of Mental Disorders, 4th edition (DSM-
IV)26 for childhood anxiety disorders (e.g., social phobia,
generalized anxiety disorder, separation anxiety disorder).
The SCAS was introduced as a new childhood anxiety
scale with evidence of adequate reliability and validity
148 – Trends Psychiatry Psychother. 2012;34(3)
for international use in the measurement of childhood
anxiety symptoms.19 The scale has already been cross-
culturally adapted to many languages, countries,
and cultures after its original Australian version was
proposed. Examples include German,27 Dutch,28 Hellenic
Greek,29 Japanese,30 Mexican,31 Arab Syrian,32 Cypriot
Greek,33 English, Swedish, and Italian.34
The objective of the present study was to describe
the cross-cultural adaptation of the SCAS (both child and
parent versions) for use in Brazil.
Method
The study protocol was approved by the Ethics
Committee of Hospital de Clínicas de Porto Alegre,
Universidade Federal do Rio Grande do Sul (number of
the project: 08-017).
Instruments
Spence Children’s Anxiety Scale (SCAS)
The SCAS contains 44 items. Of these, 38 deal with
specific anxiety symptoms, arranged in six factors or
subscales: 1) separation anxiety (six items); 2) social
phobia (six items); 3) obsessive-compulsive problems
(six items); 4) panic (six items) and agoraphobia (three
items); 5) generalized anxiety (six items); and 6) physical
injury fears (five items). The latter subscale relates to
specific phobias. The remaining six items in the SCAS
are positive filler questions used to reduce negative
response bias. There is also an open question at the end
of the questionnaire that provides the respondents with
the opportunity to report any additional fears.20,25
In each item, respondents are instructed to check
the word that best describes how often the behaviors,
feelings, and reactions described in the scale (reflecting
anxiety symptoms) happen to them. A four-point word
scale is used: never, sometimes, often, always. The
fact that there are no right or wrong answers is also
emphasized during instrument administration.20,25
Spence Children’s Anxiety Scale – Parent Version
(SCAS-P)
The SCAS also has a version developed to assess
children’s anxiety symptoms based on their parents
report.28 The items of the parents’ version (SCAS-P)
are all equivalent to the items included in the original
child version, except for the filler items, which are not
present in the SCAS-P. In the SCAS-P, parents are asked
to evaluate how often their children demonstrate the
symptoms described in the 38 items of the scale using a
four-point word scale: never, sometimes, often, always.

Steps of the cross-cultural adaptation process
First of all, the authors of the present study contacted
the author of the original SCAS scale via e-mail so that
she could authorize the cross-cultural adaptation process.
After that, a four-step process was followed, based on
specialized literature35-37 and on the International Test
Commission Guidelines for Translating and Adapting
Tests.38 The four steps were: 1) investigation of
conceptual and item equivalence; 2) translation and
back-translation; 3) pretest; and 4) investigation of
operational equivalence. These procedures were applied
to both the child and the parent versions of the SCAS.
Investigation of conceptual and item equivalence
In the first step, the scale was analyzed in terms of
conceptual and item equivalence between the original
and target contexts.35-37 Equivalence was assessed
through a literature review about childhood anxiety and
the instruments available for the assessment of anxiety
in Brazil. The objectives were: 1) to investigate if the
relationship between the scale and its underlying concept
(i.e, childhood anxiety) in the original setting would be
the same in Brazil; and 2) to investigate if the items
comprising the original scale would remain relevant and
acceptable in the Brazilian context. Literature review
and instrument analysis results were also discussed with
two experts in the field: a PhD psychologist specialized
in childhood psychopathology and a PhD psychologist
specialized in cross-cultural adaptation of instruments.
Translation and back-translation
In the second step, the scale was translated from
English into Brazilian Portuguese and then back-
translated into English. Two independent translators
produced forward-translations of the SCAS, and a third
one synthesized both translations into a single version in
Brazilian Portuguese. This synthesized version was then
back-translated independently by two other translators,
and again a third one synthesized both back-translations
into a single version in English.35,39-41 All translators
involved in this step were fluent in both languages,
English and Brazilian Portuguese.
The original version of the SCAS, the synthesized
forward-translation version, and the synthesized back-
translation version were all evaluated by an expert
committee,35,39-41 including a PhD psychologist specialized
in methodology, a PhD psychologist specialized in
childhood anxiety, a translator, and a back-translator.
The committee assessed whether the items included in
the three versions reflected the same ideas regarding
the target construct (i.e., childhood anxiety). The
objective was to make sure that the translation process
SCAS-Brasil: Brazilian version of the SCAS – DeSousa et al.
was adequately conducted and that the translated items
were relevant to the Brazilian context. Adjustment of
instrument items was performed after a consensus was
reached among all members of the committee.
Pretest
The third step of the cross-cultural adaptation
process consisted of a pilot study.35,39 The aim of this
step was to evaluate the understanding of the scale by
the target population (i.e., Brazilian children aged 7 to
12 and their parents). Eight children (four boys and four
girls) and their parents (four mothers, one father and
three couples) were requested to read and then rephrase
the sentences contained in the child and parent versions
of the scale, respectively.37 These children were recruited
from an anxiety disorders treatment program and were
from families with different socioeconomic statuses.
Answers were analyzed in an attempt to identify any
problems in the wording of the items, as well as any
confusing or misleading items. All children and parents
involved in this step of the process signed an informed
consent form prior to their participation.
Investigation of operational equivalence
In the fourth step, the scale was analyzed in terms
of the operational equivalence between the original
and target contexts.35-37 The following aspects were
evaluated considering the use of the instrument in Brazil:
instructions, method of administration, questionnaire
format, and measurement methods used in the original
SCAS. Operational equivalence was analyzed through
a literature review focusing on operational models of
other childhood anxiety instruments available in Brazil.
The results of this review were also discussed with two
experts in the field: a PhD psychologist specialized in
childhood psychopathology and a PhD psychologist
specialized in cross-cultural adaptation of instruments.
Results
Results obtained in each step of the adaptation
process for both versions of the SCAS (child and parent)
are described below. The aspects or areas where
differences emerged over the cross-cultural adaptation
process are discussed.
Investigation of conceptual and item
equivalence
As suggested by Herdman et al.,36 analyzing literature
reviews and studies that employ the basic concept of
the original instrument in the assessment of the target
Trends Psychiatry Psychother. 2012;34(3) – 149
SCAS-Brasil: Brazilian version of the SCAS – DeSousa et al.
population is a useful approach to investigate conceptual
and item equivalence of an instrument across cultures.
Silva & Figueiredo7 conducted a systematic review of
the literature about instruments that evaluate anxiety
in children and adolescents and found that, among the
118 instruments analyzed, there was a whole category
of instruments emerging as a result of a series of studies
based on the DSM-IV diagnostic criteria. One example of
instrument that fell into this category and has recently
been adapted to Brazilian Portuguese is the Screen for
Child Anxiety-Related Emotional Disorders (SCARED).42,43
In addition to the literature review, we also discussed
our results with experts in the fields of childhood
psychopathology and cross-cultural adaptation of
instruments.35 The results of this discussion pointed to
evidence of equivalence between SCAS items in both the
original and the Brazilian contexts. Both experts agreed
that the domains and theoretical rationale that served
as the basis for the original SCAS, as well as the items
representing them, were equally relevant and important
in the target context, and that the construct itself was
likely to be equally valid in Brazil.
However, both experts identified problems in one
specific item of the SCAS, present in both the child and
the parent versions: “I have [My child has] trouble going
to school in the mornings because I feel [(s)he feels]
nervous or afraid.” Differently from the Australian context,
in Brazil many children go to school only in the morning
or only in the afternoon. Therefore, even though the idea
underlying this specific item (separation anxiety symptom)
would be equivalent in Brazil, the assumption of “going to
school in the mornings” would not work for all children.
That consideration was taken into account and this item
was edited as follows: “I have [My child has] trouble going
to school because I feel [(s)he feels] nervous or afraid.”
Also, one of the experts stressed a possible problem
in another item of the parent version: “My child is scared
of heights (e.g., being at the top of a cliff).” In Brazil,
even though being scared of heights may also indicate a
symptom of a specific phobia, the example of “being at
the top of a cliff” might not be useful due to particular
experiences of the Brazilian population with geographical
terrains. As the child version of this item only states “I
am scared of being in high places,” the parent version
item was replaced with “My child is scared of heights,” by
removing the example in parentheses.
Finally, the experts suggested the inclusion of
new items to investigate anxiety characteristics that
are relevant in Brazilian settings. For instance, they
suggested the inclusion of an item specifically referring
to phobia symptoms related to burglars and thieves.
However, in order to maintain the structure of the SCAS-
Brasil as similar as possible to that of the original scale,25
150 – Trends Psychiatry Psychother. 2012;34(3)
consensus was reached that it would be preferable not to
add this item. This decision was further justified by the
fact that the last item in the SCAS prompts the respondent
to refer to anything else the child is afraid of, enabling
the respondents to provide more specific information
about other relevant symptoms and characteristics.
Translation and back-translation
The forward- and back-translations followed the steps
described above, involving six translators throughout the
process. Few items showed discrepancies between the
versions of the two independent translators and of the
two back-translators, which facilitated the task of the
translators responsible for synthesizing the versions. The
expert committee checked the synthesized forward- and
back-translations, comparing them to the original SCAS.
The committee noticed that the words “scared” and
“afraid,” used in many items of the original instrument,
were randomly translated into Portuguese as “assustado”
and “com medo,” not following a standardized pattern.
After discussing this issue, adjustments were performed
and a decision was reached about the final wording of
items in the SCAS-Brasil. Table 1 shows the original
items of the SCAS and the final versions of the Brazilian
Portuguese correlate items after the forward- and back-
translations and review by the expert committee.
Pretest
Parents did not have any problems rephrasing the
items of the scale. Out of the eight children selected for
this stage, only one had difficulty rephrasing the items:
a 7-year boy who did not have problems understanding
the items, but rather reading them. When the items
were read aloud by a research assistant, he was able to
rephrase the sentences without further difficulties.
Investigation of operational equivalence
The results of the pretest stage support the idea
that the SCAS can be used even in patients with reading
disabilities or difficulties, provided someone can read the
sentences to the subjects; this method of administration
may also be useful when dealing with illiterate parents.
There were no other sources of difficulty regarding
the format, instructions, method of assessment, or
measurement methods of the SCAS in the Brazilian
context. The review of the literature also demonstrated
that many of the instruments used for assessing anxiety
symptoms in Brazilian children follow operational
procedures similar to those of the SCAS, e.g., the
SCARED,42,43 the STAI-C,21,22 and the RCMAS.23-24
 SCAS-Brasil: Brazilian version of the SCAS – DeSousa et al.

Table 1 – SCAS original items and corresponding SCAS-Brasil items

Factor/Subscale Original item Brazilian Portuguese item

Separation Anxiety I would feel afraid of being on my own at home Eu ficaria com medo de ficar sozinho(a) em casa
(Ansiedade de I worry about being away from my parents Eu me preocupo em estar longe dos meus pais
separação) I worry that something awful will happen to Eu me preocupo que algo terrível vá acontecer com alguém
someone in my family da minha família
I feel scared if I have to sleep on my own Eu sinto medo se eu tenho que dormir sozinho(a)
I have trouble going to school in the mornings Eu tenho problemas em ir para a escola porque me
because I feel nervous or afraid sinto nervoso(a) ou assustado(a)
I would feel scared if I had to stay away from Eu ficaria com medo se eu tivesse que passar a noite
home overnight longe de casa
Social Phobia I feel scared when I have to take a test Eu fico com medo quando tenho que fazer uma prova
(Fobia Social) I feel afraid if I have to use public toilets or bathrooms Eu fico com medo se eu tenho que usar banheiros públicos
I feel afraid that I will make a fool of myself Eu fico com medo de fazer papel de bobo na
in front of people frente das pessoas
I worry that I will do badly at my school work Eu me preocupo em ir mal no meu trabalho escolar
I worry what other people think of me Eu me preocupo com o que outras pessoas pensam de mim
I feel afraid if I have to talk in front of my class Eu sinto medo se eu tenho que falar em frente a minha
sala de aula
Generalized I worry about things Eu me preocupo com as coisas
Anxiety When I have a problem, I get a funny feeling Quando eu tenho um problema, eu fico com uma
Disorder in my stomach sensação esquisita no meu estômago
(Ansiedade I feel afraid Eu sinto medo
Generalizada) When I have a problem, my heart beats really fast Quando eu tenho um problema, meu coração bate muito rápido
I worry that something bad will happen to me Eu me preocupo que algo ruim vá acontecer comigo
When I have a problem, I feel shaky Quando eu tenho um problema, eu me sinto nervoso(a)
Panic Attack I suddenly feel as if I can’t breathe when there Eu sinto como se de repente eu não pudesse
(Ataque de is no reason for this respirar quando não há razão para isso
Pânico) e I suddenly start to tremble or shake when there Eu começo de repente a tremer ou me agitar
Agoraphobia is no reason for this quando não há razão para isso
(Agorafobia) All of a sudden I feel really scared for no reason at all Eu me sinto muito assustado(a) de repente, sem razão nenhuma
I suddenly become dizzy or faint when there is no Eu fico tonto(a) ou desmaio de repente quando não há
reason for this razão para isso
My heart suddenly starts to beat too quickly Meu coração começa a bater muito rápido de
for no reason repente sem nenhuma razão
I worry that I will suddenly get a scared feeling Eu me preocupo que vou me sentir assustado(a)
when there is nothing to be afraid of de repente quando não há nada do que ter medo
I feel scared if I have to travel in the car, Eu fico assustado(a) se tenho que viajar em um
or on a bus or a train carro, um ônibus ou um trem
I am afraid of being in crowded places (like Eu tenho medo de ficar em lugares cheios de
shopping centers, the movies, buses, gente (como shoppings, cinemas, ônibus ou
busy playgrounds) parquinhos lotados)
I am afraid of being in small closed places, Eu tenho medo de estar em locais pequenos
like tunnels or small rooms fechados, como túneis ou quartos pequenos
Physical Injury I am scared of the dark Eu tenho medo do escuro
Fears (Medo de I am scared of dogs Eu tenho medo de cachorros
Danos Físicos) I am scared of going to the doctors or dentists Eu tenho medo de ir a médicos ou dentistas
I am scared of being in high places or lifts (elevators) Eu tenho medo de estar em lugares altos ou elevadores
I am scared of insects or spiders Eu tenho medo de insetos ou aranhas
Fillers (Itens I am popular amongst other kids my own age Eu sou popular entre outras crianças da minha idade
Positivos Fillers) I am good at sports Eu sou bom nos esportes
I am a good person Eu sou uma pessoa boa
I feel happy Eu me sinto feliz
I like myself Eu gosto de mim
I am proud of my school work Eu estou orgulhoso(a) das minhas tarefas escolares
Obsessive- I have to keep checking that I have done things right Eu tenho que ficar checando se eu fiz as coisas direito
Compulsive (like the switch is off, or the door is locked) (como se apaguei a luz, ou tranquei a porta)
Disorder I can’t seem to get bad or silly thoughts out of my head Parece que eu não consigo tirar pensamentos ruins ou
(Problemas idiotas da minha cabeça
Obsessivo- I have to think of special thoughts to stop bad things Eu tenho que pensar em pensamentos especiais para impedir
Compulsivos) from happening (like numbers or words) que coisas ruins aconteçam (como números ou palavras)
I have to do some things over and over again like washing Eu tenho que fazer algumas coisas repetidamente (como
my hands, cleaning or putting things in a certain order) lavar as mãos, limpar ou colocar as coisas em certa ordem)
I get bothered by bad or silly thoughts or pictures in Eu fico incomodado(a) com pensamentos ou imagens ruins
my mind ou idiotas na minha mente
I have to do some things in just the right way to stop Eu tenho que fazer algumas coisas da forma correta para
bad things happening impedir que coisas ruins aconteçam

Trends Psychiatry Psychother. 2012;34(3) – 151

SCAS-Brasil: Brazilian version of the SCAS – DeSousa et al.
Discussion
The main concept assessed by the SCAS is childhood
anxiety. As mentioned before, this concept is based on
diagnostic criteria set forth in the DSM-IV28 for childhood
anxiety disorders. Specifically, the SCAS assesses
symptoms related to the following anxiety disorders:
separation anxiety disorder, social anxiety disorder or
social phobia, obsessive-compulsive disorder, panic
disorder and agoraphobia, generalized anxiety disorder,
and specific phobias. The symptoms described in the
DSM-IV for diagnosing anxiety disorders that are
represented by the SCAS items tend to be universal,
and are therefore also used by Brazilian practitioners
and investigators to study anxiety disorders in Brazilian
populations.5,8,17,18
A major difficulty in the translation steps of this
adaptation process involved the selection of translators
and back-translators fluent in both languages. It was
necessary to find English or Portuguese native-speaker
linguists or translators with excellent fluency and a long
experience working with both languages.39,41 The difficulty
was also caused by financial constraints: none of the
translators could receive any financial compensation for
their work due to budget limitations. As a result, the time
spent translating/back-translating the instrument was
particularly long (about 5 months), mainly because one
of the translators and one of the back-translators had to
become members of the expert committee afterwards.
This illustrates well how time and financial constraints
may impose obstacles to the adoption of adequate cross-
cultural adaptation guidelines.35
In addition to evaluating the understanding of
items,35,39 another key aspect of the pretest stage in the
present study was providing evidence for the need of
alternatives to the self-answered mode of administration
of the scale. Investigating the operational equivalence of
the SCAS thus confirmed that the scale can be used with
patients with reading disabilities or difficulties with the
help of an interviewer.
Conclusion
Even though the SCAS is a well-established scale,
a careful cross-cultural adaptation process is always
recommended when dealing with a foreign instrument
in a new cultural context.35 Therefore, the procedures
followed in the present study for the adaptation of the
SCAS into Brazilian Portuguese (SCAS-Brasil) were highly
important for generating an adequate instrument for the
assessment of childhood anxiety in Brazil. According
to the International Test Commission Guidelines for
152 – Trends Psychiatry Psychother. 2012;34(3)
Translating and Adapting Tests,38 as a general guideline,
professionals should always “implement systematic
judgmental evidence, both linguistic and psychological,
to improve the accuracy of the adaptation process and
compile evidence of the equivalence of all language
versions” (p. 2).
The SCAS-Brasil here presented seems to be very
similar to the original SCAS, suggesting that future cross-
cultural studies may benefit from this early version.
However, other studies are needed in order to take on
further steps in the cross-cultural adaptation process of
the SCAS-Brasil. For example, next steps could include
administering the scale to Brazilian samples of children
and adolescents, so as to collect evidence of instrument
validity based on psychometric properties of the SCAS-
Brasil through recognized statistical methods.35,38-40
The SCAS-Brasil is presented as a new instrument
now available for the assessment of childhood anxiety
symptoms. The scale can be used in community settings,
serving as a screening tool to identify children at risk
for developing anxiety disorders, assisting in preventive
interventions. It can also be used in academic settings,
in studies designed to assess anxiety indicators or
symptoms in terms of their frequency, severity, or
structure among children and adolescents. Finally,
another possible application of the SCAS-Brasil, yet to
be tested, is its use in clinical settings, as an auxiliary
tool for diagnostic and therapeutic evaluations regarding
the structure and severity of anxiety symptoms, as well
as treatment response.
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Correspondence
Diogo Araújo DeSousa
Rua Ramiro Barcelos, 2600/104
90035-003 – Porto Alegre, RS – Brazil
Tel.: + 55-51-3308-5150
E-mail: diogo.a.sousa@gmail.com
Trends Psychiatry Psychother. 2012;34(3) – 153